HYPERCALCEMIA : SIGNS & SYMPTOMS , COMPLICATIONS , INVESTIGATIONS & MANAGEMENT
Signs and symptoms of hypercalcemia
These range from nonexistent to severe. Treatment depends on the cause.
Symptoms
There maybe no symptoms if hypercalcemia is mild.
More-severe cases produce signs and symptoms related to the parts of the body affected by the high calcium levels in the blood.
Examples include:
Kidneys.
Excess calcium makes kidneys work harder to filter it.
This can cause excessive thirst and frequent urination.
Digestive system.
Hypercalcemia can cause stomach upset, nausea, vomiting and constipation.
Bones and muscles.
In most cases, the excess calcium in the blood comes from bone resorption. This causes weakness of bones. This can cause bone pain and muscle weakness.
Brain
Hypercalcemia can interfere with normal functioning of the brain resulting in confusion, lethargy and fatigue. It can also cause depression.
Heart
Rarely, severe hypercalcemia can interfere with heart function, causing palpitations and fainting, indications of cardiac arrhythmia, and other heart problems.
Complications
Hypercalcemia complications can include:
Osteoporosis
If bone resorption continues,this releases calcium into the blood, and can lead toosteoporosis, which could lead to bone fractures, spinal column curvature and loss of height.
Kidney stones
If urine contains too much calcium, crystals might form in kidneys. Over time, the crystals can combine to form kidney stones. Passing a stone can be extremely painful.
Kidney failure
Severe hypercalcemia can damage kidneys, limiting their ability to cleanse the blood and eliminate fluid.
Nervous system problems
Severe hypercalcemia can lead to confusion, dementia and coma, which can be fatal.
Abnormal heart rhythm (arrhythmia)
Hypercalcemia can affect the electrical impulses that regulate heartbeat, causing heart to beat irregularly.
Diagnosis
Because hypercalcemia can cause few, if any, signs or symptoms, it may go un noticed until routine blood tests reveal a high level of blood calcium.
Blood tests can also show if parathyroid hormone level is high, indicating that patient will have hyperparathyroidism.
To determine if hypercalcemia is caused by a disease such as cancer or sarcoidosis, imaging of bones or lungs may be needed
More Information can be obtained by
Chest X-rays
CT scan
Mammogram
Treatment
If your hypercalcemia is mild, watch and wait policy may be adopted, monitoring bones and kidneys over time to be sure they remain healthy.
For more severe hypercalcemia, medications or treatment of the underlying disease, including surgery may be considered.
Medications
Calcitonin (Miacalcin)
This hormone from salmon controls calcium levels in the blood. Mild nausea might be a side effect.
Calcimimetics
This type of drug can help control overactive parathyroid glands. Cinacalcet (Sensipar) has been approved for managing hypercalcemia.
Bisphosphonates
Intravenous osteoporosis drugs, which can quickly lower calcium levels, are often used to treat hypercalcemia due to cancer.
Risks associated with this treatment include breakdown (osteonecrosis) of the jaw and certain types of thigh fractures.
Denosumab
This drug is often used to treat people with cancer-caused hypercalcemia who don't respond well to bisphosphonates.
Prednisone
Ifhypercalcemia is caused by high levels of vitamin D, short-term use of steroid pills such as prednisone are usually helpful.
IV fluids and diuretics.
Extremely high calcium levels can be a medical emergency that might need hospitalization for treatment with IV fluids and diuretics to promptly lower the calcium level to prevent heart rhythm problems or damage to the nervous system.
Surgical and other procedures
Problems associated with overactive parathyroid glands often can be cured by surgery to remove the tissue that's causing the problem.
In many cases, only one of a person's four parathyroid glands is affected.
A special scanning test uses an injection of a small dose of radioactive material to pinpoint the gland or glands that aren't working properly.
No comments:
Post a Comment